Antimicrobial resistance (AMR) - The role of the Swedish Board of Agriculture - prevention coordination prudent use - SVA
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Antimicrobial resistance (AMR)
The role of the Swedish Board of Agriculture
- prevention coordination prudent use
Lena Hellqvist Björnerot
Deputy CVO
2019-05-14
Outline
• Background, the importance of AMR, global views
• OIE - and EU coordinaton
• The Swedish model and strategy
historically
prevention & healthy animals
reduce the need & prudent use
cooperation
legislation, control
monitoring
• One Health, Intersectoral Coordination Function
• Summary
2019-05-14
Swedish Board of Agriculture (SBA)
SBA is the Government's expert authority in the
agro-food sector - responsible for all matters related
to agriculture & horticulture
Task - to fulfil the overall objectives of the political
sectors of agriculture, food & fisheries
Aim - Sustainable agriculture, good livestock husbandry
& a varied agricultural landscape
Being prepared for crisis
2019-05-14
SBA´s mission
Ensure good animal health among kept animals
Prevent spread, and control, of infections
among kept animals
Ensure a good animal welfare
Work for food security and consumer trust for
our part of the food chain
Sustainable food production
Profitability in farming
2019-05-14
Antimicrobial resistance
(AMR)
2019-05-14
A big threat to humanity...
WHO: Antibiotic resistance, along with the climate
issue, is one of the biggest threats to global health,
food security and development today!
Global action plan to tackle antimicrobial resistance –
2015, in Tripartite collaboration with The Food and
Agriculture Organisation (FAO) and The World
Organisation for animal health (OIE).
http://www.who.int/antimicrobial-resistance/global-
action-plan/en/
2019-05-14
A big threat to humanity...
United Nations General Assembly in New York September 2016:
A political declaration endorsed by Heads of State signaled the
world’s commitment to taking a broad, coordinated approach
to address the root causes of antimicrobial resistance across
multiple sectors, especially human health, animal health and
agriculture.
Namely all UN countries support the Global Action Plan
against Antibiotics Resistance, produced by the WHO in
cooperation with FAO and OIE
https://www.un.org/pga/71/wp-content/uploads/sites/40/2016/09/DGACM_GAEAD_ESCAB-AMR-
Draft-Political-Declaration-1616108E.pdf
2019-05-14
A big threat to the economy...
The World Bank estimates that antimicrobial resistance
(AMR) has the potential to lead to economic
consequences in the dignity of the financial crisis 2011
by the year 2050.
The World Bank's report also shows that low and middle
income countries are often the hardest hit.
http://documents.worldbank.org/curated/en/32331149
3396993758/pdf/114679-REVISED-v2-Drug-
Resistant-Infections-Final-Report.pdf
2019-05-14
‘Review on Antimicrobial Resistance. Antimicrobial Resistance:
Tackling a Crisis for the Health and Wealth of Nations. 2014.’
If increase and spread of AMR continues in the same way & rate
in 2050…
2019-05-14
https://amr-review.org/home.html
Use of antimicrobials in livestocks
Increased demand for animal protein and shift to large-
scale farms – use may increase with 67% by 2030
2019-05-14
Comment – urging for a sustainable productionOne health approach is necessary
All sectors must work together at all levels….
2019-05-14FAO
http://www.fao.org/search/en/?cx=018170620143701104933%3Aqq82jsfba7w&q=antimicrobial+resist
ance&cof=FORID%3A9&siteurl=www.fao.org%2Fabout%2Fen%2F&ref=www.fao.org%2Fhome%2Fen%2
F&ss=7432j3340152j24
2019-05-14OIE - World organisation for Animal Health
OIE Activities
against AMR
http://www.oie.int/fileadmin/Home/eng/Media_Center/docs/pdf/PortailAMR/EN_OIE-
AMRstrategy.pdf
2019-05-14OIE 4 main objectives
against AMR
• Improve awareness & understanding
• Strengthen knowledge through
surveillance & research
• Support good governance &
capacity building
• Encourage implementation of
international standards
2019-05-142019-05-14
AMR in OIE TERRESTRIAL & AQUATIC CODES
Chapter 6.7. Chapter 6.1.
Introduction to the Introduction to the
recommendations for recommendations for
controlling antimicrobial controlling antimicrobial
resistance resistance
Chapter 6.8.
Chapter 6.2.
Harmonisation of
Principles for responsible
national antimicrobial
and prudent use of
resistance surveillance
antimicrobial agents in
and monitoring
programmes
aquatic animals MANUAL OF
Chapter 6.9. Chapter 6.3.
Monitoring of the Monitoring of the
DIAGNOSTIC TESTS
quantities and usage quantities and usage
patterns of antimicrobials patterns of antimicrobial
AND VACCINES FOR
agents used in food agents used in aquatic TERRESTRIAL
producing animals animals
Chapter 6.4. ANIMALS
Chapter 6.10. Development and
Responsible and prudent harmonisation of national
Chapter 2.1.2
use of antimicrobial antimicrobial resistance Laboratory
agents in veterinary surveillance and
medicine monitoring programmes methodologies for
for aquatic animals
Chapter 6.5. bacterial
Chapter 6.11.
Risk analysis for
Risk analysis for
antimicrobial resistance
antimicrobial
antimicrobial resistance
arising from the use of
arising from the use of
antimicrobial agents in
susceptibility testing
antimicrobials in animals
aquatic animals
http://www.oie.int/en/standard-setting/terrestrial-code/access-online/
http://www.oie.int/index.php?id=171&L=0&htmfile=titre_1.6.htm
http://www.oie.int/fileadmin/Home/eng/Health_standards/tahm/2.01.01_ANTIMICROBIAL.pdf
2019-05-14OIE activities against AMR continued
List of antimicrobial agents of
veterinary importance,
in parallel with the existing
WHO list for human medicine
Global database on
antimicrobial agents
intended for use in animals
Network
2019-05-14EU legislates & EU coordinates its positions related to OIE & other international organisations EU cooperates on OIE issues with other regions, such as Africa 2019-05-14
EU – AMR Strategy key objectives
2. Boosting research,
1. Making the development and innovation
EU a best practice region
3. Shaping the global agenda
2019-05-14
https://ec.europa.eu/health/amr/action_eu_enThe Swedish animal health situation, Swedish model & AMR strategy 2019-05-14
Sweden has a unique high
animal health status
• Geographically favourable situation & climate
• No recent wars
• Financial resources
• Not so dense animal population
• Strict legislation
• Long tradition cooperation government &
stakeholders - “prevention is better than cure”
• Low volume & strict control for safe trade/imports
of live animals – but promoting trade of products
• Animal Welfare Etc…History of animal health activities
• Tuberculosis and Brucellosis eradication schemes in 1940-60
• Organizations for insemination and bovine fertility started
preventive fertility and disease control ~ 1940
• Dairy industry started preventive udder health scheme in ~1950
• Salmonella Control programme started after an outbreak 1953
• Voluntary eradication of EBL (free 2007) & BVD (free 2013)
started in the 1990-ties
• Eradication program for IBR, paratuberculosis,
Aujeszky's Disease & PRRS
2019-05-14
Now free for most of these and several other diseases!A composite strategy
against AMR is needed
Remove unnecessary use
growth promoters, routine prophylaxis
Reduce need
keep animals healthy
prevention and infection control
Avoid spread
biosecurity, infection control, food hygiene...
Optimize use when needed
correct diagnosis, selection and dose
Monitoring of resistance and use
LONG-TERM WORK. AWARENESS &
COOPERATION AT ALL LEVELS!Our tools
• Legislation
• Financial resources –
to fight epizootic diseases & support programmes
and projects run by farmers organisations to
promote animal health
• Incentives & understanding of
risks and benefits
• Cooperation
2019-05-14Remove unnecessary use Antibiotics as growth promoters prohibited in SE 1986 Corresponding prohibition in EU 2006 - important to reduce and end the use globally! Avoid routine prophylaxis - only use after veterinary prescription, clinical examination and diagnosis, sampling and sensitivity analysis! - problem solving at the root! Legislation (SBA) Global standards!
Reduce need & avoid spread Healthy animals do not need antibiotics Infection prevention & control
”THE SWEDISH MODEL”
AMR is not in isolation
• Long tradition in Sweden of “prevention is better than cure”
• Close dialogue & cooperation between stakeholders &
governmental authorities
• Knowledge & understanding of benefits!
• Stakeholder platform, yearly meetings
• Stakeholders run programs for improving animal health &
biosecurity in general (pig-, cattle-, sheep-, fish- & poultry sector)
• Focus on ”production diseases” – free of serious diseases
• One Health
• Prudent use of antimicrobials
• Animal welfare
2019-05-14Infection prevention & control
(IPC)
Important tool also in the veterinary medicine to
- prevent emergence of healthcare associated infections*
- prevent the spread of infectious agents between
animals, farms & bet ween animals – humans
Clean hands, working clothes, equipment…
- Reduce the need of antimicrobials
Mandatory for all veterinary services in Photo; Bengt Ekberg, SVA
Sweden to have IPC-plans! *e.g. MRSA
https://distriktsveterinarerna.se/download/18.1487953d1697560ebcfc49d3/1552654159983/Hygienguiden.pdf
http://www.svf.se/sv/Forbundet/Policydokument (IPC small animal veterinary clinics/hospitals; horse practice;
handling dogs & cats with specific AMR,)
http://www.jordbruksverket.se/download/18.2ae27f0513e7888ce22800010291/1370040513684/2013-014.pdfOptimize use when needed
Correct diagnosis
Correct substance, dose & time
Guidelines & treatment
recommendations
- considering risks for AMR when prescribing
- Mastitis policy; Guidance on medicated feed;
- Swedish Veterinary Association general policy (1998) &
specific guidelines for use of antibiotics in: dogs & cats;
cattle & pigs; horses; sheep & goats
- Medical Products Agency recommendations on antibiotic use
https://saveantibiotics.se/ http://skyddaantibiotikan.se/
http://www.svf.se/sv/Forbundet/Policydokument/
https://lakemedelsverket.se/veterinara-behandlingsrekommendationerUse & monitoring of
antimicrobials
• SBA is responsible for regulating the use of VMPs,
risk management and the overall control
- requirement for veterinary prescription
- veterinarians not allowed to sell VMP
- veterinary obligation to report use
• SBA obligation to compile & report the sales of VMPs
- Swedish Government - yearly report on sales
of VMPs (including antibiotics)
- ESVAC – yearly report antibiotics (Europe)
- OIE (as of 2015)
2019-05-14
Working for harmonised EU legislationSweden - use of antibiotics
Källa: Swedres-Svarm 2018
2019-05-14Europe – use of antibiotics
Sales for food-producing species, in mg/PCU,
for 30 European countries, in 2016
Eighth ESVAC report
2019-05-14
Sales of veterinary antimicrobial agents in 30 European countries in 2016. Eighth ESVAC reportOne health approach is necessary
All sectors must work together at all levels….
2019-05-14The Swedish AMR Strategy
- overall framework
Overarching goal:
Preserve the possibility for effective treatment of
bacterial infections in people and animals
First joint National Action Plan in year 2000
Joint work on zoonosis since 1990ties
https://www.government.se/contentassets/168838e186de455ca7f
e868bee92d209/swedish-strategy-to-combat-antibiotic-
resistance.pdfrnment.se/information-material/2016/05/swedish-
strategy-to-combat-antibiotic-resistance/
2019-05-14Intersectoral Coordination Function • 2012 – formalised AMR cooperation • 25 governmental authorities & organisations • National Action plan updated for 2018-2020 • Yearly forum during the European AMR-awareness day (November) • Joint communication strategy updated 2019 • https://saveantibiotics.se/ http://skyddaantibiotikan.se/ • E.g. recommendations to prevent MRSA from infected humans working with animals 2019-05-14
In summary
Cooperation
Prevention & control all levels
disease management Animal welfare
AH+PH
Knowledge
Prudent use of Understanding benefits
antimicrobials Incentives
Financing
Legislation
Long term cooperative work – understanding & motivation
is needed to achieve a change in behaviour!
2019-05-14It is possible!
Thank you for your attention
Lena Hellqvist Björnerot
Deputy Chief Veterinary Officer (Deputy CVO)
Department of Animal Health and Welfare
lena.bjornerot@jordbruksverket.se
https://www.jordbruksverket.se
2019-05-14You can also read
